## The Longevity Economist

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**Canonical URL:** [The Longevity Economist](https://www.imf.org/-/media/files/publications/fandd/article/2024/12/pie.pdf)

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### Background and biography
- Anne Case grew up in upstate New York in the 1960s and 70s, witnessing deindustrialization as shoe manufacturers and business machine factories closed and employers such as IBM began “to move on and move out.”
- Education and career path:
  - Enrolled at the State University of New York in Albany; developed a passion for econometrics and statistics after her first undergraduate economics course.
  - Earned a master’s degree in public affairs from the Woodrow Wilson School at Princeton and a PhD in economics from Princeton in 1988.
  - Worked for the World Bank for a year, later returned to Princeton and is the Alexander Stewart 1886 Professor of Economics and Public Affairs.
- Field experience included research in South Africa in the 1990s on the effects of AIDS and midlife mortality; collaborated with Christina Paxson on early-life health and later-life outcomes.
- Personal influences: “Growing up with parents who cared dearly about what happened to people less well off than themselves, that’s what led me to focus on how poorer people cope, how exactly they hold body and soul together.”

### Research focus and methodology
- Umbrella research question: How poor people manage through difficult circumstances and how disruptions to incomes affect health and well-being.
- Methodological strengths: attention to detail, empirical work, econometrics, and the ability to “pull things out of data that maybe people hadn’t looked at before.”
- Collaboration: Frequent coauthor with Angus Deaton; Deaton won the 2015 Nobel Prize in economics.

### Key findings on mortality and well-being
- Historical context:
  - By the late 1960s, advances in vaccines and antibiotics helped extend the average American lifespan to nearly 70.
  - That lifespan level was “about 50 percent longer than at the start of the century.”
  - By the 1980s, antihypertensive drugs reduced cardiovascular disease.
- Recent trends:
  - Life expectancy for adults without a college degree reached its peak around 2010 and has been falling since.
  - By 2021, people without a bachelor’s degree were living “roughly eight and a half years less than people with college degrees.”
  - About two-thirds of the US working population does not have an undergraduate degree.
- Specific causes contributing to rising midlife mortality:
  - Increases in suicide, alcohol use, liver disease, and drug overdoses—described as “deaths by one’s own hand.”
  - The overprescribing of painkillers such as OxyContin in the late 1990s, followed by cheaper heroin and synthetic opioids such as fentanyl, produced a spike in overdose deaths.
- Socioeconomic mechanisms:
  - Economic shifts—offshoring of jobs, weakening labor unions, declining church attendance, falling marriage rates—eroded community structures and employment opportunities, reducing status and earning prospects for working-class Americans.
  - These economic and social fractures contributed to unhealthy coping behaviors and worsening health outcomes across economic, social, emotional, and medical dimensions.
- Counterpoints:
  - Some critics argue that access to ever-stronger drugs explains rising mortality more than an economy-induced despair narrative.

### Policy implications and recommendations
- Health care and capitalism:
  - Case believes “capitalism needs to be put back on the rails,” particularly regarding access and affordability of health care.
- Labor and hiring practices:
  - Efforts to reduce educational discrimination are gaining traction:
    - During the past two years, according to the Brookings Institution, more than 20 states have expanded access to state government jobs by dropping requirements for an undergraduate degree.
    - These hiring reforms expand opportunities to workers who gained skills through community college, the military, partial college, certification programs, and on-the-job training.
- Broader social objectives:
  - Strengthen safety nets for those falling behind.
  - Invest in policies that create a more equitable environment for workers.
  - Address the opioid epidemic through regulatory and public-health measures that limit inappropriate prescribing and target distribution channels.

### Impact and legacy
- Case’s work, including the 2020 New York Times best-seller Deaths of Despair and the Future of Capitalism (coauthored with Angus Deaton) and subsequent essays, ignited a national discussion about challenges facing working-class Americans.
- Her research emphasizes using economic analysis to improve the human condition and has been described as “a piece of social science that joins everything together.”
- The findings warn of potential acceleration of social, economic, and educational polarization if the identified trends continue.

*Source: PIE (PDF chapter/section)*

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_Source: https://www.imf.org/-/media/files/publications/fandd/article/2024/12/pie.pdf_